AB0554 CLINICAL CHARACTERISTICS AND BURDEN AMONG PATIENTS WITH SLE STRATIFIED BY SLEDAI DERIVED SEVERITY: RESULTS FROM A REAL-WORLD STUDY IN THE US
Authors: A. Vadhariya, J. Birt, J. Wu, K. Griffing, F. Bailey, J. Hetherington, E. Rottier, S. Barlow, K. Costenbader
Journal: Annals of the Rheumatic Diseases (2022)

Background Data are limited concerning the distribution of Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores among patients with SLE in clinical practice and the characteristics of patients with specific SLEDAI scores. Objectives To investigate SLE patient demographics, clinical status, treatment patterns, and patient reported outcomes (PROs), overall and stratified by SLEDAI score. Methods Data were drawn from the Adelphi Real World Lupus IV (2021) Disease Specific Programme™, a point-in-time survey of 79 US rheumatologists and patients with SLE. Rheumatologists completed questionnaires regarding patient demographics, clinical status, and treatment. The same patients were invited to complete questionnaires containing the EuroQoL 5-Dimensions (EQ-5D), Functional Assessment of Chronic Illness Therapy Fatigue Subscale (FACIT-Fatigue) and Work Productivity &amp; Activity Impairment questionnaire (WPAI) Patient-Reported Outcomes (PRO) tools. Physicians completed 24 questions based on the SLEDAI-2K questionnaire regarding their patients’ current clinical manifestations, from which a SLEDAI score was derived 1 . Patients were grouped based on their score: SLEDAI=0 (none), SLEDAI=1-6 (mild), SLEDAI=7-12 (moderate), and SLEDAI&gt;12 (severe) 2 . Data from patients without rheumatologist-perceived renal organ involvement and ≥ 1 year of SLE duration were included for analysis using bivariate tests. Results A total of 273 patients were included in this analysis. Mean [SD] patient age was 47.0[14.2] years, 83.9% were female, 57.1% were White/Caucasian, and 24.9% were African American. Table 1. Point-in-time clinical status, treatment patterns and PROs among patients with SLE stratified by SLEDAI score Table 1. Total Sample (n=273) SLEDAI=0 (n=60, 22%) SLEDAI=1-6 (n=79, 28.9%) SLEDAI=7-12 (n=70, 25.6%) SLEDAI&gt;12 (n=64, 23.4%) p value Physician-Reported Clinical Status and Treatment History Current SLE severity, n(%) Mild 221 (81.0) 51 (85.0) 70 (88.6) 53 (75.7) 47 (73.4) 0.057 Moderate 49 (18.0) 9 (15.0) 9 (11.4) 16 (22.9) 15 (23.4) Severe 3 (1.1) 0 (0.0) 0 (0.0) 1 (1.4) 2 (3.1) Current joint symptoms, n(%) Joint tenderness 109 (39.9) 24 (40.0) 27 (34.2) 28 (40.0) 30 (46.9) 0.498 Joint stiffness 121 (44.3) 22 (36.7) 33 (41.8) 37 (52.9) 29 (45.3) 0.293 Joint swelling 60 (22.0) 17 (28.3) 13 (16.5) 19 (27.1) 11 (17.2) 0.190 Mean [SD] Flares in the last 12 months 1.6 [1.5] 1.3 [1.2] 1.7 [1.7] 1.5 [1.3] 1.8 [1.5] 0.550 Currently prescribed, n(%) Belimumab 58 (21.3) 14 (23.3) 18 (12.9) 8 (10.1) 15 (21.4) 0.011 Immunosuppressants 48 (17.6) 7 (11.7) 26 (18.6) 10 (12.7) 13 (18.6) 0.052 Corticosteroids 138 (50.6) 35 (58.3) 62 (44.3) 29 (36.7) 32 (45.7) 0.003 Antimalarials 206 (75.5) 28 (46.7) 108 (77.1) 64 (81.0) 59 (84.3) &lt;0.001 Patient-Reported Outcomes Mean [SD] EQ5D-5L Utility score (0=death to 1= full health) 0.79 [0.19] 0.83 [0.12] 0.82 [0.21] 0.79 [0.14] 0.69 [0.25] 0.024 Mean [SD] FACIT-Fatigue score (0=worst fatigue to 52= no fatigue) 32.7 [12.2] 36.8 [8.7] 36.1 [12.5] 29.1 [9.8] 26.4 [14.3] &lt;0.001 Mean [SD] WPAI overall (0= no impact to 100= completely impacted) 26.8 [21.2] 25.2 [15.8] 19.5 [23.6] 35.7 [20.2] 31.9 [26.7] 0.131 49% of SLE patients were categorized as SLEDAI 7-12 or &gt;12 (moderate or severe). Among the SLEDAI 7-12 (moderate) patients, 75.7% were subjectively categorized by their physician as having mild SLE. Of the SLEDAI &gt;12 patients (severe), 73.4% were categorized as having mild SLE. Joints symptoms and flaring in the last 12 months were not significantly different across SLEDAI groups. Patients with greater SLEDAI reported lower EQ5D and greater FACIT-Fatigue scores. There was no statistical difference in WPAI between the SLEDAI groups. Conclusion A disconnect between point-in-time SLEDAI and physician-perceived severity exists. Patients with SLE, irrespective of SLEDAI, had high prevalence of joint symptoms, but higher SLEDAI impacted quality of life. References [1]Gladman D et al., Journal of Rheumatology, 2002. [2]Fanouriakis A et al., Annals of the rheumatic diseases , 2019. Disclosure of Interests Aisha Vadhariya Employee of: Eli Lilly and Company, Julie Birt Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Jianmin Wu Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Kirstin Griffing Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Fiona Bailey: None declared, James Hetherington: None declared, Elke Rottier: None declared, Sophie Barlow: None declared, Karen Costenbader Consultant of: Lilly, Astra Zeneca, Janssen, Amgen, Glaxo Smith Kline, Grant/research support from: Exagen, Gilead, Merck